This proposal describes a five-year training program for the development of an academic career in dermatoepidemiology. The principal investigator has completed residency training in Dermatology as well as a Master's in Public Health in Epidemiology at the University of Washington and will expand upon these skills through a unique collaboration of intra-departmental and intra-institutional resources. The research will focus on epidemiological studies examining the association between use of non-steroidal anti-inflammatory drugs (NSAIDs) and the development of cutaneous squamous cell carcinomas (SCCs) using two population-based study designs. The first is a retrospective case-control study using the Group Health Cooperative electronic database, supplemented with interview data. The second study will use data from an already established population-based cohort study of 77,000 enrollees for which there are detailed pharmacy records who will be followed over a five year period for incident SCCs. These data will be used in multivariate models to examine whether anti-inflammatory therapy protects against the development of cutaneous SCCs. The specific aims of these studies are to (1) develop a reliable and valid questionnaire for ascertaining NSAID exposure, (2) quantify correlation between self-reported NSAID use and pharmacy records for NSAIDs, (3) examine if NSAID use reduces the incidence of cutaneous squamous cell carcinomas, and (4) assess how patterns of use (duration, dose, and type) of NSAIDs affect incidence of SCCs. The primary mentor is Dr. Emily White, who is a world-renowned cancer epidemiologist at the University of Washington with an area of expertise in exposure measurement. Dr. Mary-Margaret Chren, a clinical dermatologist with expertise in epidemiolgy at the University of Califomia, San Francisco, will also serve as a co-mentor. The department of Epidemiology at the University of Washington is amongst the top in the nation and provides an ideal setting for training clinically oriented research. Such an environment maximizes the potential for the principle investigator to establish a scientific niche within dermatoepidemiology from which an academic career can be launched.